| NPI | 1235799065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MD R211048) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VI AP12995) |
| 363L00000X Nurse Practitioner (Licence: MD R211048) | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2022-07-08 |